Provider Demographics
NPI:1932520111
Name:BRENNAN, AMBER NICOLE (APRN)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:NICOLE
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:HOBBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:4975 ROCK ROSE LOOP
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-9203
Mailing Address - Country:US
Mailing Address - Phone:407-832-8077
Mailing Address - Fax:
Practice Address - Street 1:2415 N ORANGE AVE
Practice Address - Street 2:SUITE 700
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-5505
Practice Address - Country:US
Practice Address - Phone:407-303-2474
Practice Address - Fax:407-303-0680
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-14
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9283335363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily